A pain in the ear that may be sharp, dull, burning, intermittent, or continuous. It may come from the hearing mechanisms themselves – the eardrum, inner ear, outer canal, or the deeper bone structure – whenever they are subject to trauma or inflammation; or it may arise from the joint of the mandible (jawbone) or elsewhere. The most common causes are otitis media and otitis externa.
Acute earache sometimes is felt during plane trips because of unequal air pressures on the two sides of the eardrum. Blockage of the eustachian tube, which normally equalizes pressure by allowing air to pass into or out of the middle ear, is a common cause of earache. This occurs in upper-respiratory-tract infections.
Because the cranial nerves of the neck, face, jaw, and scalp all collect sensory branches from the ear, earache can be caused by disorders such as dental disease, tonsillitis, nasal congestion, jaw inflammation, and cervical spine (neck) injury. Eruption of the wisdom teeth often is marked by coincident earache in adolescents, and the growth of teeth in infants frequently is accompanied by earache.
Diagnosis of the cause is important to ensure there is no serious ear disease. Treatment, apart from relief of pain, may include the administration of antibiotic drops for the ear, removal of excess earwax, and dental assessment. In young children with otitis media, appropriate treatment is necessary to prevent the complications of chronic infection that may damage hearing.